Yet Another Celebrity Overdose
Expansion of Medicaid has greatly improved things for those at the low end, but we seem to have greater difficulty coming up with a decent solution for the crazy stuff that can sometimes happen at the very top.
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…they may have purchased what they believe to be cocaine, or methamphetamine, or heroin, any or all of which may have been ‘cut’ with fentanyl or another uber-potent synthetic opioid, in sufficient quantity to overcome their tolerance and put them in imminent danger of death.
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Back in Court — Pill Mill edition
A lone physician was found to have prescribed more than 500,000 doses of prescription opioids to assorted patients in little more than two years of medical practice.
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Physician or Vending Machine?
…some patients feel ‘gypped’ if they don’t leave the office with a prescription. And respond with a bad review on the patient satisfaction survey.
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A Disturbing Trend in Prescribing
This in spite of the fact … that these drugs can and often do interact harmfully with one another. And regular users are at elevated risk for misuse, abuse, dependence, and/or addiction.
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Death Letter
The researchers were interested in whether receipt of such a letter would cause the physician to be more cautious in prescribing in future. The answer: It did.
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MDs Confronting SUDs
I imagine it takes a special kind of practitioner to push aside the barriers in the system to get to the SUD that lies underneath, even when he or she knows it’s there.
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A Problem in Prescribing?
…no more than 7.4% of overdose patients had received a prescription for naloxone following an overdose. That covers both the initial visit and any follow-up contacts the hospital required.
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Hospital Consults — Are They Worth It?
I asked a number of the attending docs if they’d spoken with the patient about the problem, and was startled by how rarely the answer was yes.
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Self-Disclosing
…with any helping relationship, I think it’s best to restrict self-disclosure to situations where you believe it will advance the goals of treatment.
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Doctors and Alcohol Disorders
Definite progress has been made, but there are still plenty of examples of people who fall through the cracks in the healthcare system.
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Prescription for Violence
I heard one man exclaim in a packed hospital waiting room. “It’s her damn job. She took an oath.” I was struck by his sense of entitlement. And I could envision how, enhanced by withdrawal and desperation, it could turn violent.
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The Pill Pusher’s Tale
Smaller government is not always better government. It shouldn’t take a major health crisis to remind us.
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